From Billy Graham to Trump era, he has engaged North Korea. It’s a lonely calling.

The late evangelist Billy Graham visited the birth place of leader Kim Il Sung in Pyongyang, North Korea on January 28, 1994 in this photo from North Korea’s official Korean Central News Agency, distributed by Korea News Service. Second from the left is Stephen Linton, who served as Graham’s translator and advisor on two trips and has continued to engage Pyongyang, and the U.S., on a campaign to help North Koreans suffering from tuberculosis.
The late evangelist Billy Graham visited the birth place of leader Kim Il Sung in Pyongyang, North Korea on January 28, 1994 in this photo from North Korea’s official Korean Central News Agency, distributed by Korea News Service. Second from the left is Stephen Linton, who served as Graham’s translator and advisor on two trips and has continued to engage Pyongyang, and the U.S., on a campaign to help North Koreans suffering from tuberculosis. AP

Stephen Linton knew he was walking into a diplomatic minefield when he accompanied Billy Graham on the evangelist’s first visit to North Korea in 1992.

Graham, an international religious leader and staunch anti-communist, was not the kind of visitor North Korea normally welcomes. Yet the nation’s supreme leader at the time, Kim Il Sung, quickly took a liking to Graham, who worked to demonstrate he was there as a neutral, non-political actor, not an agent of the U.S. government.

“He sought to present himself as a religious leader who transcended politics,” said Linton, who served as Graham’s translator and adviser on that trip and a subsequent one in 1994. “This clicked with the North Koreans. Kim Il Sung found him to be very interesting.”

It was hardly a coincidence that Graham, who passed away Wednesday at age 99, used this strategy to click with the nation dubbed as the “Hermit Kingdom.” Linton urged him to. For more than three decades, Linton has argued that humanitarian groups need to assert their independence and forge direct relationships with North Korea, arguably the world’s most isolated country.

The offspring of three generations of Korea-based Southern Presbyterian missionaries, Linton heads the Eugene Bell Foundation, a Christian charity that treats thousands of North Koreans afflicted with drug-resistant tuberculosis. A part-time resident of South Carolina, Linton grew up in South Korea, speaks fluent Korean and has traveled to North Korea more than 80 times over nearly four decades, a record of engagement that few, if any, U.S. citizens can match.

With a Ph.D. in Korean studies from Columbia University, Linton is also somewhat of an iconoclast. He’s a critic of major NGOs and the United Nations bureaucracy, which doesn’t endear him among fellow humanitarians. He avoids public criticism of North Korea’s human rights record, which disappoints human rights activists. He opposes hard sanctions on North Korea, which has put him in the cross hairs of U.S. hawks calling for “maximum pressure” on the regime.

Yet among those who specialize in trying to understand North Korea, Linton is widely respected, and watched.

“This guy is sort of a legend,” said Stephan Haggard, a North Korea expert with the Peterson Institute and the University of California, San Diego. “So many NGOs have come and gone in North Korea, but he’s managed to maintain an operational presence there for many years.”

Linton is unsure how many more years that will be. He’s long been able to visit North Korea and travel in its rural regions, even amid the most heated incidents involving the Kim family dynasty. But Kim Jong Un’s nuclear and missile tests and President Trump’s threats against North Korea have elevated the prospects of war. And even if the Korean peninsula avoids another military conflict, new sanctions against Kim’s regime have made it harder for the Eugene Bell Foundation to access the country, ship materials there and treat patients.

All the while, North Korea’s tuberculosis epidemic is raging. While Linton’s foundation treats 1,500 patients a year, he estimates that thousands more go untreated, passing on a mutant form of the disease that is difficult and expensive to control, much less eradicate.

“We have to enroll enough patients to slow down the increase or watch this disease spread,” said Linton. “We are in a race against time.”

Spreading the gospel in “Jerusalem of the East”

There are few American families with a deeper history in Korea than Linton’s. His foundation is named after his great grandfather, Eugene Bell, a Southern Presbyterian missionary from Kentucky who transplanted his family to Korea in the 1890s.

At the time, Pyongyang was known as a hub of Christianity — the “Jerusalem of the East.” After the communists seized control of neighboring Russia, that mission of converting Koreans took on extra urgency. It’s one reason that Christians are a majority in South Korea today.

Eugene Bell’s son-in-law, William A. Linton, founded what is now Hannam University, a private Christian university in Daejeon, South Korea. Stephen Linton’s parents were also Southern Presbyterian missionaries, establishing scores of churches across Korea and working to treat tuberculosis patients.

Linton himself was born in 1950, at the start of the Korean War. He later grew up in a rural portion of South Korea, becoming fluent in the language and determined to become a scholar in Korean history.

While Linton was teaching at Columbia in the early 1990s, Graham expressed interest in visiting North Korea, and sought Linton’s help. Linton had first traveled to North Korea in 1979 to attend an international table tennis tournament, where he established his first contacts in Pyongyang. Such contacts helped open the door for Graham’s visit in 1992.

The evangelist’s arrival in Pyongyang was controversial, given that few non-communist figures had made goodwill visits to North Korea. But in contrast to some modern evangelists, Graham believed it was important to spread the gospel to all corners of the world, even in regimes seen to be enemies.

“Christianity has always been about surviving in countries hostile to its values,” said Linton.

Graham and Linton made a return visit in 1994, soon after President Bill Clinton signaled he might launch a military strike against North Korea’s budding nuclear weapons program. During that visit, Graham met again with Kim Il Sung, passed on a blunt message from Clinton and tried to convey the president’s sincerity in resolving the impasse. According to Linton, Kim Il Sung noticeably brightened upon hearing about Clinton’s intentions, and extended an invitation for the U.S. president to visit North Korea.

Clinton never acted on that offer, but former president Jimmy Carter that year paid a visit to Pyongyang and negotiated a nuclear deal that defused the crisis — at least temporarily.

Linton was prepared to go back to his comfortable job at Columbia, but within a year, North Korea had spiraled into famine. He then founded the Eugene Bell Foundation to provide food assistance to starving North Koreans. Over time, at the urging of North Korean officials, it evolved into a tuberculosis charity, providing medicines and treatment training to clinics across the north.

By 2008, Stephen Linton’s foundation estimated it had treated 250,000 patients, the vast majority of which might have otherwise died. But it was increasingly encountering forms of tuberculosis resistant to normal antibiotics. Linton had stumbled upon a lethal legacy of North Korea’s Soviet era.

“We are losing this fight”

Tuberculosis, an infectious bacterial disease, kills more than 1 million people worldwide each year, mostly in poor countries, but not exclusively. Even developed South Korea has a relatively high rate of the disease. Linton himself contracted it as a child. In North Korea, the disease is more widespread, afflicting 440 of every 100,000 people, compared to just three of 100,000 in the United States.

Doctors typically treat tuberculosis with four kinds of antibiotics, involving at least six months of treatment. But patients can become resistant to the drugs if their treatment ends before they are cured, or contract the disease from another patient who has developed what is known as “multidrug-resistant” TB.

Starting during the Soviet era in North Korea, following War II, doctors tended to use a limited number of drugs on TB patients, creating the conditions for resistance. While the nation’s health ministry has long tested for regular tuberculosis, it was unaware that mutant form had spread so widely.

Dr. Kwonjune Seung, a Korean-American doctor who works with the Eugene Bell Foundation, credits Linton for recognizing the proliferation of drug-resistant TB. “He was the first outsider to notice this,” said Seung. “In talking to the North Korean doctors, he was finding a lot of patients not being cured with normal TB drugs.”

Since 2008, Eugene Bell has focused exclusively on treating drug-resistant TB, purely with private donations. Today, it cares for about 1,500 patients at any given time, with each one undergoing 18 months of therapy with a mixture of six highly toxic drugs. Each treatment costs about $5,000.

Every six months, 500 patients are “graduated” from the treatment, and 500 more are added. The program claims a 75 percent rate for treating drug-resistant TB, far higher than the world average.

One challenge of doing humanitarian work in North Korea is preventing donated supplies from being diverted before they reach the people who need them. Reports of diverted supplies have discouraged numerous potential donors, who fear the regime will end up profiting from their generosity.

Eugene Bell has sought to counter such concerns by hand carrying medicines directly to the 12 clinics its serves. At least twice a year, Linton and his team visit these clinics in southwestern North Korea, deliver medicine and check on the progress of patients. The visits are videotaped, so donors can see boxes of medicine going to specific patients they have agreed to help.

In 2010, following a change of government in Seoul, numerous South Korean NGOs were blocked from direct contact with the north, leaving Eugene Bell as one of the few charities on the ground. But Linton doesn’t crow about his group’s accomplishments. The number of drug-resistant TB patients in North Korea keeps growing. “I would say that we are losing this fight so far,” he told a Korean podcast in 2015.

North Koreans spurned by many U.S. givers

On a recent afternoon, Linton and his wife Hyuna attended a Sunday service of the Church of the Lord, a Korean-American church in Burke, Va. It’s a congregation that has long supported the Eugene Bell Foundation, but its faithful are growing grayer, and smaller in number.

Following a prayer and the singing of hymns, Linton was invited to address those assembled. Standing at the lectern in his three-piece suit, Linton bore a slight resemblance to the actor Sam Waterston, with his angular cheekbones and hooked nose. Speaking in Korean and English, Linton rattled off the challenges his foundation faces in North Korea, amid increased sanctions and the threat of war.

It’s a regular Sunday outing for the Lintons, who met in Seoul a decade ago. When not in North and South Korea, they spend about half their time in the United States, where they have a home in Andrews, S.C. Even then, they are regularly on the road fundraising, often in churches and most often in Korean-American churches.

A few years ago, Linton made an attempt to boost U.S. fundraising outside of Korean congregations. The effort was a bust. He blames it on “the plug-and-play ideological thinking we have in this country.”

“People see Korea as good guys, bad guys and victims. They think that to the save the victims, the good guys need to defeat the bad guys.”

When talking to sympathetic audiences, the Lintons often play videos of the TB clinics in North Korea. The videos show emaciated TB patients, gasping for breath and often hauled to the clinics on the backs of their relatives. There’s also heart-tugging footage of Eugene Bell workers interacting with North Korean clinicians, who are seen breaking into tears after losing a child or young adult to the disease.

Dr. Hie C. Kim, who was in the audience during Linton’s recent presentation, said he has long contributed to the foundation, partly to foster reconciliation between North and South Korea, where he was born 78 years ago. “We are one country,” said Kim, a lung surgeon who moved to the United States in 1968.

Linton wants to expand the number of treatment centers in North Korea, but to do that, he’ll need to raise more money both for medicines and new patient wards. Recent international sanctions are complicating that task. Linton wants to ship prefabricated building walls through China and into North Korea, but the walls contain metal, and the new sanctions ban metal imports into North Korea.

Linton said the international restrictions “have made China and South Korea nervous about anything to do with metal.” Others back up his claim.

“While humanitarian NGOs are not targeted by the sanctions, they are experiencing collateral damage,” said Keith Luse, executive director of the National Committee on North Korea, which represents several charities doing work within the country.

An “apologist”? Or neutral player?

While cautious in talking about North Korean regime, Linton has never been shy about critiquing U.S. policy in the region. He sees sanctions as “economic warfare” and counterproductive in pressuring Pyongyang to end its nuclear weapons program. In his view, sanctions harden the North Koreans’ perspective that the world economic system is organized against them, forcing them to find leverage — nukes — to protect their interests.

Speaking to the libertarian CATO Institute in 2010, he asserted that the United States missed chances over the decades to take advantage of overtures from North Korea.

“How did we happen to blow it?” he asked the CATO audience. “How did we happen to stand here 30 years later not only without that relationship but arguably in a worse position than we were when we started?”

During this month’s Olympics in Pyeongchang, Linton watched with interest as South Korea’s president, Moon Jae In, ruffled relations with the United States by meeting with Kim Jong Un’s sister, prompting Kim to invite Moon to meet with him in North Korea.

“What we are seeing is the future,” said Linton. “The East Asians will work out a solution to their security issues, and U.S. will play a much more marginal role in the region.”

Such comments have not endeared Linton to some U.S. security analysts. Joshua Stanton, a hardline advocate of sanctions against North Korea, faults Linton for remaining silent about North Korea’s gulags and human rights abuses. In a 2007 post on his One Free Korea blog, Stanton called Linton “an academically brilliant, knowledgeable and exceptionally articulate apologist with the capacity to reach influential audiences, including the U.S. Congress.”

Asked about such criticisms, Linton scoffed at being labeled “pro-North Korean.” He said he’s simply trying to engage North Korea with discourse that is neutral, the kind of dialogue that he encouraged Billy Graham and others to pursue.

Linton also pushed back against criticism that the work of Eugene Bell relieves Pyongyang of the burden of caring for drug-resistant TB patients. “It is obvious if we didn’t do it, it wouldn’t get done,” he said.

While Linton has testified to Congress, and at one time was regularly invited to talk to think tanks and intelligence agencies in D.C., those invitations have largely dried up. The reason, he said, is he has chosen to remain independent of the U.S. policy apparatus, so he can continue to do humanitarian work in North Korea.

“Groups like the CIA and FBI soon I realized I was not going to provide them with operational intelligence. They were not getting names of people I met with,” he said. “But as I told them, ‘You would not want me to give North Koreans your names, so why would I give you their names?’”

Stuart Leavenworth: 202-383-6070, @sleavenworth